title: Epidemiology of fractures in Iceland and secular trends in major osteoporotic fractures 1989-2008.
abstract: The incidence of the most common fracture types in Iceland is reported based on individual data from the Reykjavik Study 1967-2008. Time trend is reported for the major osteoporotic fractures (MOS) 1989-2008.
  
  
  BACKGROUND
  This study aims to assess the incidence of all fractures in Iceland, with emphasis on the rate of hip fractures, and compare the incidence with other populations as well as examine the secular changes.
  
  
  METHODS
  Individuals from the prospective population-based cohort Reykjavik Study were examined between 1967 and 2008 (follow-up 26.5 years), which consisted of 9,116 men and 9,756 women born in 1907-1935, with age range 31-81 years. First fracture incidence was estimated using life table methods with age as the timescale.
  
  
  RESULTS
  Fracture rate increased proportionally with age between the sexes for vertebral and proximal humerus but disproportionally for hip and distal forearm fractures. The ratio of first fracture incidence between the sexes varied considerably by site: 2.65 for hip fractures and the highest for distal forearm fractures at 4.83. By the age of 75, 36.7% of women and 21% of men had sustained a fracture, taking into account competing risk of death. The incidence of hip fractures was similar to results previously published from USA, Sweden, Norway, and Scotland. The incidence of MOS fractures in both sexes decreased over the last decade, except hip fractures in men, which remained unchanged, as reflected in the women/men ratio for the hip, which changed from 2.6 to 1.7.
  
  
  CONCLUSIONS
  This study adds information to scarce knowledge on the relative fracture incidence of different fractures. The incidence of MOS fractures increased in the latter part of the last century in both sexes and declined during the last decade, less dramatically for men. This information is important for planning health resources.
authors.affiliation: Icelandic Heart Association Research Institute, Holtasmari 1, IS-201, Kopavogur, Iceland, kristin@hjarta.is.
authors.forename: K
authors.initials: K
authors.lastname: Siggeirsdottir
authors.forename: T
authors.initials: T
authors.lastname: Aspelund
authors.forename: B Y
authors.initials: BY
authors.lastname: Jonsson
authors.forename: B
authors.initials: B
authors.lastname: Mogensen
authors.forename: E F
authors.initials: EF
authors.lastname: Gudmundsson
authors.forename: V
authors.initials: V
authors.lastname: Gudnason
authors.forename: G
authors.initials: G
authors.lastname: Sigurdsson
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005543:Forearm Injuries / Q000453:epidemiology; D005544:Forecasting; D050723:Fractures, Bone / Q000453:epidemiology*; D006620:Hip Fractures / Q000453:epidemiology; D006801:Humans; D007055:Iceland / Q000453:epidemiology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D058866:Osteoporotic Fractures / Q000453:epidemiology; D011446:Prospective Studies; D017678:Sex Distribution